Provider Demographics
NPI:1285627992
Name:MOJICA, ROSA LYNN SAMANIEGO (DMD)
Entity type:Individual
Prefix:DR
First Name:ROSA LYNN
Middle Name:SAMANIEGO
Last Name:MOJICA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:S
Other - Last Name:MOJICA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:1331 NORIEGA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4409
Mailing Address - Country:US
Mailing Address - Phone:415-661-3330
Mailing Address - Fax:415-731-0619
Practice Address - Street 1:1331 NORIEGA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-4409
Practice Address - Country:US
Practice Address - Phone:415-661-3330
Practice Address - Fax:415-731-0619
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA424841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice